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Individual

DR. CORY C BUTZON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1514 VERNON RD, LAGRANGE, GA 30240-4131
(706) 812-2369
(706) 845-3194
Mailing address
1514 VERNON RD, LAGRANGE, GA 30240-4131
(706) 812-2369
(706) 845-3194

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
003630
GA
208000000X
Pediatrics Physician
Primary
068124
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
003125382A
GA
Enumeration date
06/29/2009
Last updated
10/31/2019
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